Approximately 13% (or 9.4 million) of all children under age 18 have special health care needs. These children require health services beyond that generally required by children. In the US, up to 45% of all children use a form of complementary or alternative medicine (CAM), but only 34% of families report such use to physicians. Cultural perspectives and beliefs about health care influence decisions families make about treating their children, including their use of CAM. Health care providers are encouraged to incorporate the family into health care decisions. The World Health Organization (WHO) and NINR encourage health care providers to ensure that patients and their families receive care compatible with their cultural health beliefs and preferred language. Old Order Amish (referred to as Amish) families use alternative therapies to treat their children's' health problems, but they do not prohibit their members from seeking treatment from biomedical health care providers. The interaction of Amish cultural beliefs and CAM practices and their relationships with health care professionals in managing their child's illness have not been studied. The purpose of this research is to identify: 1) CAM practices used by Amish families caring for children with special health care needs (CSHCN) and 2) how Amish families work with health care providers to incorporate CAM and biomedical health care for children. The proposed ethnographic design is an ideal method to unveil the role of ethnicity in a cultural, family, and community approach to caring for CSHCN. It will become evident through the research process what barriers and facilitators exist for these families at a societal level. The subjects participating in this study will include Amish families who have a CSHCN, Amish community members, and health care providers who interact with Amish families with CSHCN. In addition, the process will unveil the perspectives of biomedical and traditional health care practitioners towards treatment of these Amish families. This research study about the Old Order Amish will provide a unique opportunity to study the interaction of CAM and biomedical health practices in a faith-based ethnic group. It is important for medical professionals to understand the use of CAM within families of various cultures and how it is used for their CSHCN in order to incorporate this knowledge into individualized health plans. This knowledge will enable public health professionals to better serve such communities. [unreadable] [unreadable] [unreadable]